WHAT YOU SHOULD KNOW ABOUT MEDICAL BILLS AND BRAIN INJURY
Let’s face it, your injured, your hurting, your confused, the last thing you need to do is go to your mailbox and find a stack of medical bills with confusing codes, tricky terminology and lots of dollars signs. But ignoring these bills will not make them go away. If fact, the more you ignore them, the more bothersome they become.
Depending on how you were injured will determine the type of insurance needed to help with your medical expenses.
- In the event you are in a car accident, your car insurance may include Personal Injury Protection, (PIP) or Med-Pay, this is insurance that travels with the vehicle that the victim was driving or was a passenger in. PIP Insurance covers lost wages, medical bills and other expenses. Both PIP and Med-Pay are no-fault coverages. This means that you are covered for medical bills from your injuries regardless of who was at fault for the accident. PIP coverage in only mandatory in some states, and the coverage varies from state to state in terms of both what is covered and what types of treatment are considered customary and reasonable. In some states, PIP is subrogable, meaning that your insurance carrier will pay for your loss, regardless of liability, and then recover (or subrogate) what it paid from the liable party’s insurance carrier. Many states that do not have PIP coverage have Auto Medical Payments coverage, or AMP, and some states even have both. AMP is also a first party coverage, without regard to liability, but is only subrogable in a few states, and generally optional. AMP & PIP limits range from $1500.00 to $250,000.00 depending on the injury and the state.
- The at-fault driver is also responsible for paying your medical bills. However when you are injured by an at-fault driver who has little or no insurance, your insurance company may be legally required to cover your medical costs, lost income and compensation for your pain and suffering. In many states, the law now mandates that vehicle owners carry Uninsured Motorist (UM) or Under-insured Motorist (UIM) coverage. UM or UIM coverage protects you if you suffer a bodily injury due to the negligent actions of an uninsured or underinsured motorist. These types of coverage also protect you if you are injured as a pedestrian or by a hit and run driver. Just so you know, your own insurance carrier now has the right to use the same defenses that the other driver may have had against you. So your insurance company is no longer on your side.
- Health Insurance is another option in paying for medical bills. Your health insurance will pay your medical bills from an accident just like any other injury or disease you may use your health insurance for coverage. However, there is a catch to this, by paying your medical bills, the insurance company acquires the legal right of asserting a subrogation lien. This means that you may be responsible for paying back any money, from you settlement proceeds, that the insurance company has paid out on your behalf. If you do not pay back this lien, you risk losing your benefits.
- In the event you are injured on the job, most employees have an absolute right to medical care for any injury, and in many cases, monetary payments to compensate for resulting temporary or permanent disabilities. Employees are also entitled to receive a portion of his or her lost wages. Most employers are required to subscribe to insurance for workers’ compensation. Workers’ compensation is administered on a state-by-state basis, with a state governing board overseeing varying public/private combinations of workers compensation systems. Texas is the only state that has an elective workers compensation system.
- Medicare is a health insurance for people who are 65 or older and for persons under the age of 65 who have certain disabilities. Medicare insurance has two parts: Part A, which helps pay inpatient care you get in a hospital, skilled nursing facility or home health care. Most people do not have to pay a monthly premium for this as they have paid Medicare taxes while working. Part B, which helps pay for medically necessary doctors services and other outpatient care. Most people pay the standard monthly Medicare Part B premium. If you are under the age of 65, while going through brain trauma rehabilitation, it is possible to apply for benefits such as medicare to help pay the growing medical bills. But you need to know that the Medicare Secondary Payer (MSP) statute makes Medicare the secondary payer where payment/settlement has been made or can be expect to be made.Medicaid is health insurance available to certain people and families who have limited income and resources. The rules for counting your income and resources usually depend on which state you live in. Even if you are not sure whether you qualify, if your income is limited and if you need health care, you should apply for Medicaid and have a qualified caseworker in you state look at your situation. People with Medicaid may also get coverage for services such as nursing home care. Depending on your state rules, you may be asked to pay a co-pay for some medical services. If you qualify for both Medicare and Medicaid, most of your health care costs will be covered.
- The Social Security and Supplemental Security Income disability programs are the largest of several Federal programs that provide assistance to people with disabilities. While these two programs are different in many ways, both are administered by the Social Security Administration and only individuals who have a disability and meet medical criteria may qualify for benefits under either program.Social Security Disability Insurance pays benefits to you if you are “insured,” meaning that you worked long enough and paid Social Security taxes; or
Supplemental Security Income pays benefits based on financial need.
When you apply for either program, the Social Security Administration will collect medical and other information from you and make a decision about whether or not you meet Social Security’s definition of disability.
Use the Benefits Eligibility Screening Tool on their website to find out which programs may be able to pay you benefits.
If your application is denied, the Internet Appeal is a starting point to request a review of our decision about your eligibility for disability benefits. (Please see additional information on our website regarding SSDI)
- Negotiating a large medical bill may be the single best way to reducing your medical bills. You should know that 60% of the consumers who asked a doctor or hospital for a discount on the account balances they owed did receive one in exchange for a faster payment. Your first step would be to ask the hospital billing office and/or doctor’s office to reduce your bill to the Medicare rate or make them an offer you can afford. Most important is that before making any payments, get the agreement in writing. Have the business office fax, email or mail a signed statement of the settlement upon which you agreed. A verbal commitment will not stand up in court.
- Your last option, of course, could be the credit card, but there is something you should know before you borrow money on a credit card to cover medical expenses and that is credit cards are secured debts and they cannot be negotiated. A medical bill is unsecured or forgivable and can be negotiated down. Secured debts can have a more profound impact on your credit rating than medical debt, so be careful when reaching for a credit card to pay a medical expense.